Appalachian District Health Department

Policy and Procedure Policy Name Personnel Policies Policy Topic PA/NP/Physician Coverage

Section 100

Approved Date: 11-22-06

Chapter 105

Revision Date:

Purpose: To ensure physician coverage for all Nurse Practitioners (NP) employed by Appalachian District Health Department. Policy: It is the policy of Appalachian District Health Department to comply with statutes: NCAC 36.0803, NCAC 36.0804, NCAC 36.0805, NCAC 36.0806, NCAC 36.0807, NCAC 36.0808, NCAC 36.0809, NCAC 36.0810, NCAC 36. 0811, NCAC 36.0812, NCAC 36.0813, NCAC 36.0814 (copy attached) to ensure appropriate registration, physician coverage, continuing education, prescribing authority, and quality assurance for all NP’s employed by the agency. Procedure for Physician Coverage and Medication Prescribing: a. The primary or backup physician and the nurse practitioner shall be continuously available to each other for consultation by direct communication or telecommunication. b. Services provided by the nurse practitioner will always be within the established written guidelines for plan of care or with the primary or backup physician’s consultation, either by phone or in person. c. The nurse practitioner and physician will assure one another through supervised practice that the nurse practitioner has the knowledge and the skills to assess, diagnose, and prescribe treatment as indicated by clinical guidelines. d. When the primary physician is out of the office, he/she will be available by phone; if not, the backup physician will be available by phone. e. The primary supervising physician and the nurse practitioner will discuss and evaluate the process for the ongoing review of care provided. f. During the first six months of the initial collaborative practice agreement there shall be: a. Review and countersigning of notations of medical acts by a primary or back-up supervising physician within seven days of NP – patient contact. b. Meetings with primary collaborative physician on a weekly basis for one month after approval to practice is received and then at least monthly for a total of six months. g. After the first six months of the collaborative practice agreement scheduled meetings between the nurse practitioner and the primary supervising physician will take place at least every six months. h. Documentation of the meetings between the NP and supervising physician will include clinical issues discussed and actions taken. The notes will be signed and dated by those attending, and they will be available for review for five calendar days. i. Medications shall be prescribed as necessary and in accordance with state and federal law. The NP may also order any controlled substances covered by the NP’s DEA permit. j. Emergencies will be addressed by calling 911, and the physician will also be notified immediately. 1|Personnel Policies –PA/NP/Physician Coverage